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Kidney Week

Abstract: PO0281

Lower Transferrin Saturation (TSAT) Is Associated with Worse Health-Related Quality of Life (HRQOL) in Non-Dialysis CKD (NDD-CKD) Patients Independently from Hemoglobin (Hb) Levels

Session Information

Category: Anemia and Iron Metabolism

  • 200 Anemia and Iron Metabolism

Authors

  • Guedes, Murilo Henrique, Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil
  • Muenz, Daniel G., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Zee, Jarcy, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Lopes, Marcelo, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Wachter, Sandra, Vifor Pharma Ltd, Glattbrugg, Zurich, Switzerland
  • Stengel, Benedicte, Centre de Recherche en Epidemiologie et Sante des Populations, Villejuif, Île-de-France, France
  • Massy, Ziad, Centre de Recherche en Epidemiologie et Sante des Populations, Villejuif, Île-de-France, France
  • Speyer, Elodie, Centre de Recherche en Epidemiologie et Sante des Populations, Villejuif, Île-de-France, France
  • Finkelstein, Fredric O., Yale University, New Haven, Connecticut, United States
  • Sesso, Ricardo, Universidade de Sao Paulo, Sao Paulo, São Paulo, Brazil
  • Pisoni, Ronald L., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Robinson, Bruce M., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Pecoits-Filho, Roberto, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
Background

Iron Deficiency (ID) is a common condition in NDD-CKD patients that is associated with poorer outcomes. However, the effect of ID on HRQOL in this population is unknown. We analyzed real world data from a multinational cohort of ND-CKD stage 3 to 5 patients to test the association between TSAT and ferritin with HRQOL.

Methods

Patients from Brazil (N=205), France (N=2015), and the US (N=293) in the Chronic Kidney Disease Outcomes and Practice Patterns Study (CKDopps, 2013 to 2019) with TSAT, ferritin, and HRQOL data were included. We grouped patients according to TSAT and ferritin levels closest to the HRQOL measurement. Our primary analyses evaluated the associations of TSAT and ferritin with mean differences in physical component summary (PCS) and mental component summary (MCS). Secondary analyses evaluated joint TSAT and ferritin categories, as well as additional pre-specified HRQOL measures. Linear mixed models were adjusted for potential confounders including Hb level.

Results

2513 patients were included. In the primary analyses, TSAT ≤15% and both ferritin <50 ng/mL and ≥300 ng/mL were associated with worse PCS scores, while MCS was not directionally associated with iron parameters (Figure). Patients with the composite TSAT ≤15%/ferritin ≥300 ng/mL had lower functionality scores and worse PCS, compared to those with TSAT between 20-30% and ferritin 50-299 ng/mL. Adjustment for Hb only slightly attenuated the effects, and the results were similar for subgroups of patients with Hb <11.5 vs ≥ 11.5 g/dL .

Conclusion

Low TSAT levels, and both low and high ferritin levels, are associated with poorer physical HRQOL in ND-CKD patients, even after adjustment or stratification by Hb level. Intervention studies of iron therapy on HRQOL among ND-CKD individuals are needed to confirm these findings.

Funding

  • Commercial Support